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Still Waters

Barring walk-in patients from A&E considered

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The health secretary, Jeremy Hunt, has floated the idea of stopping walk-in patients from attending hospital emergency departments in an attempt to head off a winter crisis in the health service.

NHS England has denied it plans to pilot an idea that would require patients to consult their GP or NHS 111 before being allowed to go to A&E.

However, Dr Helen Thomas, its national medical adviser for integrated urgent care, said the health secretary was considering testing the idea. 

https://www.theguardian.com/society/2017/oct/13/jeremy-hunt-considers-barring-walk-in-patients-from-ae

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The world has gone mad.

Hormones-re-thing.gif

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I think I'm not understanding the language- Brit vs American lingo here..

GP is general practitioner I assume, is NHS111 like the U.S. 911 emergency system? And I'm used to walk in clinics for non-emergency, Emergency Room for emergency situations... What is an A&E?

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'Accident and Emergency'.

NHS111 is a phone number you call to discuss your symptoms and then the doctor who answers suggests whether or not you need to go to the A. and E. dept. at the nearest hospital.

edit to say: 999 is the number we call in an emergency(fire dept., police or ambulance required).

Edited by ouija ouija

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3 minutes ago, ouija ouija said:

'Accident and Emergency'.

NHS111 is a phone number you call to discuss your symptoms and then the doctor who answers suggests whether or not you need to go to the A. and E. dept. at the nearest hospital.

edit to say: 999 is the number we call in an emergency(fire dept., police or ambulance required).

Thanks ouija. That sounds almost like a cross between walk-in and ER here. With walk-in clinics, it's preferred if you call your GP first to see if you can get in with them, then make an appointment with the walk-in clinic if they can't get you in. People can just walk in too. It's for stuff like when folks have bad colds, or other non-emergency situations. ER is more the emergency stuff, like broken bones and needing stitches when people walk in, it's where the ambulances go on 911 calls.

When I worked medical, one of the campuses I was at had the walk-in clinic and the ER on the same campus- different buildings. Even though the preferred procedure was to call GP before walk-in, you didn't have to as far as the medical system was concerned. But sometimes the persons insurance companies had a procedure for it, and covered stuff differently depending on if people followed the insurance procedure. Some people's insurance charged different between walk-in and ER, so people would try going to the walk-in for ER stuff. Couple times that happened, they ended up having to be sent via ambulance across the parking lot, and ended up with that extra ambulance bill.

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I'm more and more coming to think that the only way to make the NHS work is to take it out of the hands of Government altogether. 

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That's madness, and it will result in deaths.

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A&E: When a service is free it gets abused no doubt, question or debate about it. 11% of people who attend A&E are none emergency. 35% leave without receiving any treatment. im not surprised we are reaping the consequence of the Governments policy, we've been living for sometime under the nanny state, the adverse to danger society, etc...a minor injury is now seen as life threatening. i'll just pop up to A&E to be on the safe side. no, no - the procedure should always be GP first, followed by phoning the 111 service. unless its life threatening then its 999 and A&E.

Me Myself i hate the idea of going to Hospital in any capacity. whatever happened to waiting three days before even thinking of phoning the Doctors or going to A&E if you was still alive after 3 days it wasn't serious.

little bit of trivia or fact of the day if your in the UK and dial 666 instead of 999 the Ambulance arrives up upside down. :D no, if you dial 911, 112. on a Mobile in the UK you still get through to the Emergency operator. - land line 999.

 

 

 

 

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1 hour ago, Manfred von Dreidecker said:

I'm more and more coming to think that the only way to make the NHS work is to take it out of the hands of Government altogether. 

Before that even, a good start would be to ditch all the managers.

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I'm not sure how things are there, but here we had the problem of people not being able to afford to go to the doc...so they got sicker and sicker until they ended up in the emergency room. 

That's more expensive than covering doctor visits. 

 

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I am all for far better education about what counts as an emergency and what will heal itself with basic care in the home.  No-one should think of seeing a doctor with a head cold unless they have underlying health issues or it develops into something that causes pain or difficulty in breathing.  There will always be a grey area but most things cure themselves within a week or with painkillers and simple home care within seven days.  People should be shown pictures of injuries that require stitches and those that require a band aid.  One drop of blood and many people freak out.  One itsy little pain anywhere and they are dying.  We have been nannied long enough. I grew up in the 50/60s and a doctor was for serious illness and a hospital was for life threatening illness or injury.

Here in UK it is not unknown for people to call ambulances to be used as taxis!  Working in general practice, one of the doctors I worked for told us about being called out because someone couldn't sleep and on another occasion a woman wanted him to bring her some sanitary pads!  Madness, all of it.

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1 hour ago, ouija ouija said:

Before that even, a good start would be to ditch all the managers.

The NHS does seem top loaded with managers, but how do you run the trust, the organisation which is the biggest employer in Europe, the 3rd Biggest employer in the world, that's the scale, reducing managers is not the solution to the problems and neither is more and more money.

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19 minutes ago, stevewinn said:

The NHS does seem top loaded with managers, but how do you run the trust, the organisation which is the biggest employer in Europe, the 3rd Biggest employer in the world, that's the scale, reducing managers is not the solution to the problems and neither is more and more money.

That's just the thing though Steve, why does it need (so-called) so many managers? Because it's such a gigantic bureaucracy. Why is it such a gigantic bureaucracy? Because it has so many managers. Which came first? Is this much bureaucracy necessary to provide "Front Line" services? or is this much bureaucracy needed to maintain such an enormous bureaucracy? Are all these Trusts and all these levels of "organisation" really needed, or are they just needed to run such a gigantic bureaucracy? It's exactly the same with Councils; our local County Council are forever bleating that they're having to make "unprecedented levels of cuts", and do things like cut bus services to save something utterly piddling like £30,000 a year (which wouldn't buy one Executive car), but do they ever consider making reductions in the number of Managers and Senior Executives? do they buffalo.

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1 hour ago, Susanc241 said:

I am all for far better education about what counts as an emergency and what will heal itself with basic care in the home.  No-one should think of seeing a doctor with a head cold unless they have underlying health issues or it develops into something that causes pain or difficulty in breathing.  There will always be a grey area but most things cure themselves within a week or with painkillers and simple home care within seven days.  People should be shown pictures of injuries that require stitches and those that require a band aid.  One drop of blood and many people freak out.  One itsy little pain anywhere and they are dying.  We have been nannied long enough. I grew up in the 50/60s and a doctor was for serious illness and a hospital was for life threatening illness or injury.

Here in UK it is not unknown for people to call ambulances to be used as taxis!  Working in general practice, one of the doctors I worked for told us about being called out because someone couldn't sleep and on another occasion a woman wanted him to bring her some sanitary pads!  Madness, all of it.

I totally agree with you but I think there is something else playing into it. There's an awful lot of scare-mongering in the media with regard to 'catching disease early/nipping it in the bud'. Cold/flu symptoms, headaches etc. could all indicate something serious so don't take a chance, see your doctor right away! So many people don't trust their ability to understand what their body is manifesting and they certainly don't trust their body to heal itself.  Plus, no one is interested any more in resting the body while it heals itself.

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A&E is for when you break your leg or have a heart attack.

Too many people go there because they have a cold or a hangover or small cut ....   And that is where the problem lies. 

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2 hours ago, Manfred von Dreidecker said:

That's just the thing though Steve, why does it need (so-called) so many managers? Because it's such a gigantic bureaucracy. Why is it such a gigantic bureaucracy? Because it has so many managers. Which came first? Is this much bureaucracy necessary to provide "Front Line" services? or is this much bureaucracy needed to maintain such an enormous bureaucracy? Are all these Trusts and all these levels of "organisation" really needed, or are they just needed to run such a gigantic bureaucracy? It's exactly the same with Councils; our local County Council are forever bleating that they're having to make "unprecedented levels of cuts", and do things like cut bus services to save something utterly piddling like £30,000 a year (which wouldn't buy one Executive car), but do they ever consider making reductions in the number of Managers and Senior Executives? do they buffalo.

I don't know enough to answer your point, Why does it need so many managers? maybe these links will help answer.

https://www.kingsfund.org.uk/publications/articles/big-election-questions-bureaucracy-nhs

We'll see if the manager argument as any influence apparently the number of managers in the NHS as fallen by 18% in 7 years. (2010-2017)  

http://digital.nhs.uk/catalogue/PUB23803

https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-staffing-numbers

 

 

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We have something similar here in Portugal in place, can´t say I disagree

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Actually, that is what I always thought A&E was for and not for anyone who is feeling a little under the weather.

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